Help, I ve Fallen and Can t Get Up! Evidence-Based Strategies for Fall Prevention in Community- Dwelling Older Adults
|
|
- Mabel Blair
- 7 years ago
- Views:
Transcription
1 Help, I ve Fallen and Can t Get Up! Evidence-Based Strategies for Fall Prevention in Community- Dwelling Older Adults Jean F. Wyman, PhD, GNP, FAAN Center for Gerontological Nursing School of Nursing University of Minnesota Minneapolis, MN 1
2 Falls Are Prevalent 33% aged 65+ years 50% aged 80+ years Rates are highest in women 40-50% of fallers will have repeat falls
3 Falls Are Morbid Events Falls are the 8th leading cause of death in older adults 1 Mortality risk increases with advancing age, especially in those aged 80+ White and black males have highest death rates Black women have lowest death rate 33% of hip fracture patients will die within 1 year of injury, with rates highest in men 2 1 Centers for Disease Control, Jiang HX et al. J Bone Miner Res 2005;20:
4 Fatal and Nonfatal Fall Injuries Among People 65+, U.S million 12, ,000 1,230,000 1% - Died 24% - Treated in ED & hospitalized 76% - Treated in ED and released? Millions Fall related injuries Nonfatal falls: NEISS-AIP, 2002 Fall deaths: NCHS, Vital Records, 2002
5 Severity of Fall Injuries Injury % of All Falls Minor soft tissue injuries: Serious injuries: Fractures: 2-10 Hip Fracture: 1-2 Other common sites: Vertebrae, forearm, leg, ankle, pelvis, upper arm, & hand Injury rates highest in women with fracture diagnoses 2.2 times more common
6 Falls Lead to Functional Decline 25-75% of hip fracture patients do not recover prefracture level of function in ambulation or activities of daily living 1 Fallers have greater functional decline at 1 and 3 yrs than nonfallers 2 1 Magaziner J et al. J Gerontol Med Sci 1990;45:M101-M107 2 Tinetti ME & Williams CS. J Gerontol A Biol Sci Med Sci, 1998;53;M112-M119
7 Falls Lead to Fear and Loss of Confidence In a large population-based study of adults aged 72 and over 1 24% report a fear of falling 19% restrict activity because of their fear In other studies, fear of falling: Increases with age Is higher in women Is present both nonfallers and fallers 1 Stevens JA, Sogolow ED. Inj Prev 2005; 22:
8 Falls are Expensive $7.8 billion in total direct medical costs of fall-related care for adults aged 65+ in adjusted 2002 dollars (using 1997 fall & cost data) 1 Acute medical care costs: 2 Hospitalization: $17,483 Emergency Department visit: $ 236 Outpatient office visit: $ Carroll NV, Slattum PW, Cox FM. J Manag Care Pharm 2005;11: Roudsari BS, Ebel BE, Corso PS et al. Injury 2005;36;
9 Falls Affect Others Impact on caregiver Emotional Lost productivity Financial cost
10 Fall Etiology: Interaction Between Multiple Factors Older Person Age associated changes Chronic diseases Acute illness, hospitalization Medications Challenges to Postural Control Environmental hazards Usual activities Changing position Mediating Factors Risk-taking behavior Opportunity Mobility Physical activity Fall King MB & Tinetti ME. J Am Geriatr Soc 1995; 43:
11 Falls are Predictable % Percent Falling % 19% 32% 60% Number of Fall Risk Factors Tinetti ME, Speechley M, & Ginter SF. N Engl J Med 1988; 319:
12 Risk Factors for Falls: (N = 16 Multivariate Studies) Relative Risk Ratio (RR) or Odds Ratio (OR) Predicting Falls Muscle weakness History of falls Gait deficit Balance deficit Use assistive device Visual deficit Arthritis Impaired ADL Depression Cognitive impairment Age > 80 years AGS, BGS, & AAOS Panel on Falls Prevention. J Am Geriatr Soc, 2001; 49: Mean RR or OR
13 Medication Use Increases Fall Risk 4 or more medications Recent dosage change Drug type: Neuroleptics (especially phenothiazines) Sedatives, hypnotics (including benzodiazepines) Antidepressants (eg, TCAs, MAOIs, SSRIs, SNRIs) Antiarrhymthmics (Class 1A) Quinidine, procainamide, disopyramide Anticonvulsants Glitazones Alcohol
14 The Environment Can Cause Falls Slippery or uneven surfaces Poor lighting (dim, glare) Cluttered pathways Tripping hazards (cords, throw rugs) Unstable furniture (eg, too low or high, on casters, pedestal tables) Shelves too high or low Clothing and footwear
15 Fall Prevention Principles Identify high risk individuals Treat underlying disease Reduce modifiable fall risk factors Promote maximal functional ability and mobility Optimize bone strength and protection
16 Cochrane Review (2003): What Interventions Work? In a review of 62 randomized controlled trials, strategies determined as likely to be effective were: Multidisciplinary, comprehensive risk factor screening and intervention programs Unselected populations in the community Those with history of falling Those with known risk factors Gillespie LD, Gillespie WJ, Robertson MC et al. Cochrane Database Syst Rev 2003;4:CD000340
17 Cochrane Review (2003): What Interventions Work? Exercise for balance and strength individually prescribed by a trained professional Tai Chi group exercise program Home hazard assessment & modification professionally prescribed for the older faller Discontinuation of psychotropic medication Gillespie LD, Gillespie WJ, Robertson MC et al. Cochrane Database Syst Rev 2003;4:CD000340
18 Rand Meta-Analysis of Fall Prevention Trials (2004) In a review of 40 randomized controlled trials: Combining all types of interventions, there was a significant reduction in risk of falling and monthly rate of falling Most effective: multifactorial assessment and management program Next most effective: exercise (reduces falls by 13%- 24%) No effect: home modifications and education Chang JT, Morton SC, Rubenstein LZ et al. 2004;BMJ;328:
19 Optimizing Bone Strength: Protecting Against Fractures Weight-bearing exercise and strength training If no contraindications, minimum supplementation of calcium (1,200 mg/d) and vitamin D ( mg/d) However, evidence from the Women s Health Initiative using calcium carbonate (1000 mg/d) plus vitamin D (400 IU/d) in 32,282 postmenopausal women aged years reported: Although hip bone density was higher in the calcium plus vitamin D group than placebo, it did NOT significantly reduce hip fractures and it increased kidney stone risk Jackson RD, et al. N Engl J Med 2006;354:
20 Optimizing Bone Strength: Protecting Against Fractures For the older adult at high risk of fracture: Drug therapy Bisphosphonate therapy (e.g., alendronate, risendronate) Selective estrogen receptor modulators (raloxifene) Hormone replacement therapy in selected patients Synthetic parathyroid hormone (teriparatide) Calcitonin in those with prior osteoporotic fractures Hip protectors
21 Cochrane Review: Hip Protectors (2004) Meta-analysis of 14 randomized controlled trials of hip protectors in long-term care institution or community No evidence on effectiveness from studies in which randomization was by individual patient within institution or by those living at home Some evidence of effectiveness from cluster randomized studies for older adults at high risk of hip fracture living in institutional settings Adherence/compliance is a problem which may be related to skin irritation, abrasion, and local discomfort Parker MJ, Gillespie LD, Gillespie WJ. Cochrane Database Syst Rev. 2004;3:CD001255
22 Fall Evaluation & Prevention Program Trial National Institute of Nursing Research and Office of Research on Women s Health, National Institutes of Health (R01 NR05107) 22
23 Purpose Test the efficacy of a multifactorial fall prevention program (exercise, education, tailored counseling) in reducing falls in community-dwelling older women deemed at risk for falling
24 Intervention Components Comprehensive fall risk assessment by nurse practitioner Home-based exercise program Fall prevention education Tailored risk reduction counseling Provision of 2 nightlights
25 Program Length 28 week program in 2 phases: 12 weeks, alternating weekly home visits and telephone calls by registered nurses 16 weeks, tapered interactive computerized telephone calls for support and monitoring
26 Exercise Program Incorporated principles from Transtheoretical Model of Behavior Change Developing awareness Helping relationship Goal setting Personal testimonies Identifying rewards for exercise adherence Exercise monitoring with daily logs Teaching exercise relapse prevention strategies Exercise regimen Walking program (30 minutes for minimum 5 days/week) Balance, strength, and coordination exercises
27 Exercises 12 repetitions, twice a week Alternate knee touches Sideway walking Crossover stepping Tandem walking Toe lifts Sit to stand* Heel lifts* Single leg stand* Hip abduction* Hip extension* Step ups* * Done while wearing weighted belt
28 Fall Prevention Education Fall causes Safety proofing home Safe medication use Taking time -Avoiding rushing -Getting up slowly -Answering phone calls -Walking on ice/ slippery surfaces Balance tips for daily activities Limiting alcohol use Vision care and lighting Foot care and shoe selection Osteoporosis prevention Urinary control strategies Getting up from a fall
29 Tailored Risk Reduction Counseling Based on comprehensive fall risk assessment Written fall risk profile developed and shared Counseling with mutual goal setting and action plan for 3 fall risk factors Referrals provided as needed to health care providers, medical equipment suppliers, and handimen services
30 Sample Characteristics Mean age: 79 years (range 70-99) 98% white 60% high school education 52% $20,000/year incomes 39% fell in past year Average of 3 chronic conditions for which they took 3.5 drugs/week 8% used a cane or walker
31 Fall Frequency at 2-Years Percent of Participants or more Number of Falls Fall Prevention Health Education
32 Fall Rate Per 100 Person Years at 1- and 2-Years Follow- Up Fall Prevention Heath Education Incidence Rate Ratio (95% Confidence Interval) 1-Year* ( ) 2-Year** ( ) *P <.01 ** P <.001
33 How Much Can the Fall Prevention Program Reduce Falls? 35% fall reduction at 1 and 2 years Time Period 1-year Risk Factors Highly Predictive of Falls Older age Number of falls in prior year Number of medications with fall risk Urge incontinence Cardiovascular disease Severe hearing loss Poor vision Stroke 2-years Number of falls in prior year Number of medications with fall risk Poor vision
34 Fall-Related Injuries Over 2-Years N um ber of Falls Fall Prevention (148 falls) Health Education (238 falls) None Minor Moderate or Severe Number of Falls Fall Prevention Health Education Severity of Injury Number of Falls Resulting in Fractures
35 Fall Rates per 100 Person- Years by Exercise Adherence at 2 Years Walking Low High Balance Low High 63.7 (n=50) 82.1 (n=16) 58.0 (n=15) 40.9 (n=50
36 Conclusions Falls are common, serious, and costly in older adults Falls are multifactorial in origin, with several interacting causes Falls are preventable with multicomponent programs most effective
Fast Facts on Osteoporosis
Fast Facts on Osteoporosis Definition Prevalence Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an
More informationQuestion ID: 6 Question type: Intervention Question: Does treatment of overactive bladder symptoms prevent falls in the elderly?
PRIORITY BRIEFING The purpose of this briefing paper is to aid Stakeholders in prioritising topics to be taken further by PenCLAHRC as the basis for a specific evaluation or implementation projects. QUESTION
More informationModule 4: The Biggest Fear Falls
Module Introduction Module 4: The Biggest Fear Falls Module 4 addresses one of the biggest concerns within any assisted living facility falls. As we encourage older adults to move more, it is natural to
More informationMULTI-FACTORIAL FALL RISK ASSESSMENT AND INTERVENTION FOR COMMUNITY DWELLING SENIORS: THE ROLE OF HOME HEALTH AGENCIES. Caring Choices.
MULTI-FACTORIAL FALL RISK ASSESSMENT AND INTERVENTION FOR COMMUNITY DWELLING SENIORS: THE ROLE OF HOME HEALTH AGENCIES Caring Choices April 2006 Caring Choices Page 1 Multi-Factorial Fall Risk Assessment
More informationPreventing Falls & Injuries. Dr. Gregory Gatchell Assistant Professor UC Irvine Geriatrics
Preventing Falls & Injuries Dr. Gregory Gatchell Assistant Professor UC Irvine Geriatrics Objectives Define fall and discuss common causes of falls. Discuss consequences of falls. Discuss home safety.
More informationThe Stopping Elderly Accidents, Deaths & Injuries (STEADI) Tool Kit for Health Care Providers
The Stopping Elderly Accidents, Deaths & Injuries (STEADI) Tool Kit for Health Care Providers Disclaimer: The findings and conclusions in this presentation are those of the author and do not necessarily
More informationFalls Risk Assessment: A Literature Review. The purpose of this literature review is to determine falls risk among elderly individuals and
Falls Risk Assessment: A Literature Review Purpose The purpose of this literature review is to determine falls risk among elderly individuals and identify the most common causes of falls. Also included
More informationPrevention of Falls and Fall Injuries in the Older Adult: A Pocket Guide
INTERNATIONAL AFFAIRS & BEST PRACTICE GUIDELINES Prevention of Falls and Fall Injuries in the Older Adult: A Pocket Guide 2 Introduction to the Pocket Guide This pocket guide resource has been summarized
More informationTitle Older people s participation and engagement in falls prevention interventions: Comparing rates and settings
Title Older people s participation and engagement in falls prevention interventions: Comparing rates and settings Keywords: patient adherence; falls, accidental; intervention studies; patient participation;
More informationFalls and falls injury prevention activity audit for residential aged care facilities
Falls and falls injury prevention activity audit for residential aged care facilities National Ageing Research Institute October 2009 www.nari.unimelb.edu.au This tool is based on a tool that was originally
More informationX-Plain Vertebral Compression Fractures Reference Summary
X-Plain Vertebral Compression Fractures Reference Summary Introduction Back pain caused by a vertebral compression fracture, or VCF, is a common condition that affects thousands of people every year. A
More informationStrength Training HEALTHY BONES, HEALTHY HEART
Strength Training HEALTHY BONES, HEALTHY HEART No matter what your age, strength training can improve your bone health and your balance. As we age, our bones lose both tissue and strength. This condition
More informationReducing Falls in a Care Environment Workbook
Reducing Falls in a Care Environment Workbook 1 Welcome! Welcome to this workbook which goes with the scenarios from the Falls DVD or You Tube clips for East Midlands HIEC Falls Prevention project. We
More informationPreventing Patient Falls
Preventing Patient Falls Patient Falls are the #1 cause of ALL sentinel events. All patients at Doctors Community Hospital are assessed for fall risk and, as appropriate, the Fall Risk Protocol is implemented.
More informationU.S. Fall Prevention Programs for Seniors
U.S. Fall Prevention Programs for Seniors Selected Programs Using Home Assessment and Modification DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention U.S. Fall Prevention
More informationOTAGO Exercise Programme
OTAGO Exercise Programme To prevent falls in older adults Created by: Accident Compensation Corporation (ACC), New Zealand Implemented by: Erie County Senior Services, Independent Health & Willcare Foreword
More informationAccident Prevention: Slips, Trips & Falls
Accident Prevention: Slips, Trips & Falls Judith Davies BSc (Hons) SROT Falls Service Development and Project Manager Central Norfolk NHS East of England Ambulance Service NHS Trust Slips, Trips & Falls
More informationFrom Hospital to Home: Fall Prevention in an Acute Care Setting
From Hospital to Home: Fall Prevention in an Acute Care Setting Patricia A. MacCulloch MS, APRN, BC Adult Nurse Practitioner UMass Memorial Dept. of Orthopedics Mission UMass Memorial is committed to improving
More informationDrug treatment pathway for Osteoporosis in Postmenopausal Women
Drug treatment pathway for Osteoporosis in Postmenopausal Women Version 1.0 Ratified by: East Sussex HEMC Date ratified: 26.01.2011 Job title of originator/author Gillian Ells, East Sussex HEMC Pharmacist
More informationT. Franklin Williams
Falls in Older Adults: Implementing Research in Practice University of Leuven February, 2012 Mary Tinetti MD T. Franklin Williams Symposium: Valpreventie bij ouderen 1 Phases in the research First phase:
More informationMeasure #41: Osteoporosis: Pharmacologic Therapy for Men and Women Aged 50 Years and Older National Quality Strategy Domain: Effective Clinical Care
Measure #41: Osteoporosis: Pharmacologic Therapy for Men and Women Aged 50 Years and Older National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY
More informationProfessor Keith Hill, School of Physiotherapy and Exercise Science Curtin University Keith.Hill@Curtin.edu.au
Professor Keith Hill, School of Physiotherapy and Exercise Science Curtin University Keith.Hill@Curtin.edu.au Curtin University is a trademark of Curtin University of Technology CRICOS Provider Code 00301J
More informationIN-HOME QUALITY IMPROVEMENT BEST PRACTICE: FALL PREVENTION NURSE TRACK
IN-HOME QUALITY IMPROVEMENT BEST PRACTICE: FALL PREVENTION NURSE TRACK Best Practice Intervention Packages were designed for use by any In-Home Provider Agency to support reducing avoidable hospitalizations
More informationFalls Prevention and Management
Falls Prevention and Management Best Practices Initiative Ministry of Health and Long-Term Care Presentation Prepared By: Hazelynn Kinney Regional Best Practice Coordinator - Central East Region Based
More information16. ARTHRITIS, OSTEOPOROSIS, AND CHRONIC BACK CONDITIONS
16. ARTHRITIS, OSTEOPOROSIS, AND CHRONIC BACK CONDITIONS Goal Reduce the impact of several major musculoskeletal conditions by reducing the occurrence, impairment, functional limitations, and limitation
More informationThe menopausal transition usually has three parts:
The menopausal transition usually has three parts: Perimenopause begins several years before a woman s last menstrual period, when the ovaries gradually produce less estrogen. In the last 1-2 years of
More informationOsteoporosis Treatments That Help Prevent Broken Bones. A Guide for Women After Menopause
Osteoporosis Treatments That Help Prevent Broken Bones A Guide for Women After Menopause June 2008 fast facts Medicines for osteoporosis (OSS-tee-oh-puh-ROW-sis) can lower your chance of breaking a bone.
More informationRoSPA CONFERENCE BELFAST. From little acorns. Goal. Jane Steven GOAL BACKGROUND EFFECTS OF FALLS & FRACTURES FALLS COLLABORATIVE DEVELOPMENTS
RoSPA CONFERENCE BELFAST From little acorns Jane Steven Falls & Fracture Prevention Coordinator GOAL BACKGROUND EFFECTS OF FALLS & FRACTURES FALLS COLLABORATIVE DEVELOPMENTS Goal To reduce falls in the
More informationHow To Treat An Elderly Patient
1. Introduction/ Getting to know our Seniors a. Identify common concepts and key terms used when discussing geriatrics b. Distinguish between different venues of senior residence c. Advocate the necessity
More informationOsteoporosis and Arthritis: Two Common but Different Conditions
and : Two Common but Different Conditions National Institutes of Health and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD 20892 3676 Tel: 800 624 BONE or 202 223 0344 Fax:
More informationAGS REHABILITATION/ POST-HOSPITAL CARE OF THE GERIATRIC FRACTURE PATIENT. Egan Allen, MD University of Rochester
AGS REHABILITATION/ POST-HOSPITAL CARE OF THE GERIATRIC FRACTURE PATIENT Egan Allen, MD University of Rochester THE AMERICAN GERIATRICS SOCIETY Geriatrics Health Professionals. Leading change. Improving
More information2-1. Osteoporose. Dr. P. Van Wettere Radiologie en medische beeldvorming
2-1 Osteoporose Dr. P. Van Wettere Radiologie en medische beeldvorming 2-2 Osteoporose Definitie Incidentie, mortaliteit, morbiditeit, kost Diagnose Radiologie Botdensitometrie FRAX FractureCascade History
More informationSlips, Trips and Falls Prevention
Slips, Trips and Falls Prevention Session Objectives Recognize slips, trips, and falls as a serious safety problem Identify slip, trip, and fall hazards Avoid or eliminate slip, trip, and fall hazards
More informationWhat are the main risk factors for falls amongst older people and what are the most effective interventions to prevent these falls?
What are the main risk factors for falls amongst older people and what are the most effective interventions to prevent these falls? ABSTRACT This report is HEN s response to a question from a decision-maker.
More informationTRADIES NATIONAL HEALTH MONTH HEALTH SNAPSHOT
TRADIES NATIONAL HEALTH month AUGUST 2016 TRADIES NATIONAL HEALTH MONTH HEALTH SNAPSHOT Prepared by the Australian Physiotherapy Association ABOUT THE TRADIES NATIONAL HEALTH MONTH SNAPSHOT Marcus Dripps,
More informationOccupational Therapy Submission for falls and Fractures Prevention.
Occupational Therapy Submission for falls and Fractures Prevention. July 2007 Submitted on behalf of AOTI by: Tadhg Stapleton, Lecturer in Occupational Therapy, Discipline Of Occupational Therapy, Trinity
More informationII. RESIDENT FALL AND INJURY ASSESSMENT - DATA RETRIEVAL WORKSHEET
II. RESIDENT FALL AND INJURY ASSESSMENT - DATA RETRIEVAL WORKSHEET Date: Unit: Nurse Completing Audit: Shift Completed: Falls can be a symptom of other disease processes and should be seriously considered
More informationHealthy Steps. Your guide to falls prevention and home safety
Healthy Steps Your guide to falls prevention and home safety Are you at risk for a fall? The best way to keep yourself safe and independent in your home is to know where the risks are. Risks include: Having
More informationProgram Approved by AoA, NCOA. Website: www.homemeds.org
MEDICATION MANAGEMENT IMPROVEMENT SYSTEM: HomeMeds SM The HomeMeds SM system is a collaborative approach to identifying, assessing, and resolving medication problems in community-dwelling older adults.
More informationHow To Take A Bone Marrow Transplant
Drug treatments to protect your bones This information is an extract from the booklet, Bone health. You may find the full booklet helpful. We can send you a copy free see page 5. Contents Bisphosphonates
More informationBone Basics National Osteoporosis Foundation 2013
When you have osteoporosis, your bones become weak and are more likely to break (fracture). You can have osteoporosis without any symptoms. Because it can be prevented and treated, an early diagnosis is
More informationFall into Fall. Fall prevention in-service for Dementia clients. Lisa Reidinger LNHA,CSW,CTRS, CDP National Council of Certified Dementia Practioners
Fall into Fall Fall prevention in-service for Dementia clients Lisa Reidinger LNHA,CSW,CTRS, CDP National Council of Certified Dementia Practioners Falls and the elderly Falls are responsible for 1 in
More informationCalcaneus (Heel Bone) Fractures
Copyright 2010 American Academy of Orthopaedic Surgeons Calcaneus (Heel Bone) Fractures Fractures of the heel bone, or calcaneus, can be disabling injuries. They most often occur during high-energy collisions
More informationTai Chi: Moving for Better Balance Development of a Community-Based Falls Prevention Program
Journal of Physical Activity and Health, 2008, 5, 445-455 2008 Human Kinetics, Inc. Tai Chi: Moving for Better Balance Development of a Community-Based Falls Prevention Program Fuzhong Li, Peter Harmer,
More informationNovember 2014. 3. This submission focuses on the following areas:
November 2014 Arthritis Research UK response: Centre for Policy on Ageing and Local Government Association call for evidence on local government s response to an ageing society 1. Arthritis Research UK
More informationFalls Awareness & Prevention Guide
Falls Awareness & Prevention Guide Prepare your home or assist a loved one today by following these fall-proofing recommendations, courtesy of the American Academy of Orthopaedic Surgeons and The Orthopaedic
More informationStroke Rehabilitation - Evidence Based Practice
Stroke Rehabilitation - Evidence Based Practice Section 1 1) What percent of stroke patients are left with moderate functional impairment? a) 25% b) 40% c) 55% d) 70% 2) Which is not a component of the
More informationMedications to Prevent and Treat Osteoporosis
Medications to Prevent and Treat Osteoporosis National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD 20892-3676 Tel: (800) 624-BONE or
More informationNATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Rehabilitation of Patients With Fragility-Related Fractures CE APPLICATION FORM
NATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Rehabilitation of Patients With Fragility-Related Fractures CE APPLICATION FORM First Name: Last Name: Mailing Address: City: State: Zip/Postal
More informationStand with your feet hip-width apart and your weight equally distributed on both legs (A).
Introduction to balance exercises Balance exercises can help you maintain your balance and confidence at any age. Balance exercises can also help prevent falls and improve your coordination. For older
More informationPOLICY #: PAGE: 126.853 2 of 6 PEDIATRIC FALL PREVENTION PROGRAM FALL PREVENTION PROGRAM:
PS1006 SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY TITLE: PEDIATRIC FALL PREVENTION EFFECTIVE DATE: REVISED DATE: POLICY TYPE: Job Title of Reviewer: Director, Women & Children s Department (pediatrics)
More informationCatholic Mutual..."CARES"
Catholic Mutual..."CARES" BACK INJURY LOSS CONTROL FOR HEALTH CARE FACILITIES Occupational back injuries are a major loss exposure in the health care industry. Serious back injuries can result when employees
More informationBack & Neck Pain Survival Guide
Back & Neck Pain Survival Guide www.kleinpeterpt.com Zachary - 225-658-7751 Baton Rouge - 225-768-7676 Kleinpeter Physical Therapy - Spine Care Program Finally! A Proven Assessment & Treatment Program
More informationPassive Range of Motion Exercises
Exercise and ALS The physical or occupational therapist will make recommendations for exercise based upon each patient s specific needs and abilities. Strengthening exercises are not generally recommended
More informationTool 5 Multifactorial falls risk assessment and management tool (includes an osteoporosis risk screen)
Tool 5 Multifactorial falls risk assessment and management tool (includes an osteoporosis risk screen) Name of resident: DOB: Room no.: Name of assessor: Date of assessment: Record all risks and actions
More informationS.P.O.T. REPORT. Inside this issue: Firelands Regional Medical Center s. p. 2. p. 3. p. 4. p. 5
Volume 2 Summer 2015 Firelands Regional Medical Center s S.P.O.T. REPORT Your quarterly guide to new information, insights, and events from Speech, Physical, & Occupational Therapies at Firelands Regional
More informationVitamin D Deficiency in Older Patients
Fourth Year Medical Students Required Written Patient Care Assignments Reflecting Awareness of Use of Vitamin D in Older Patients at Risk for Falling John Agens, M.D. Associate Professor in Geriatrics
More informationHow To Choose A Biologic Drug
North Carolina Rheumatology Association Position Statements I. Biologic Agents A. Appropriate delivery, handling, storage and administration of biologic agents B. Indications for biologic agents II. III.
More informationResearch Article. Walking ABSTRACT. Authors: Affiliations: Correspondence:
Authors: Hiroyuki Shimada, PhD, PT Shuichi Obuchi, PhD, PT Taketo Furuna, PT Takao Suzuki, MD, PhD Affiliations: From the Department for Prevention of Dependence on Long-Term Care (HS, SO) and the Department
More informationBalance and Vestibular Center Programs to treat dizziness and reduce your risk of falling
Balance and Vestibular Center Programs to treat dizziness and reduce your risk of falling Helping you overcome dizziness and vertigo Most people will experience dizziness at some point in their lives.
More informationMedications and Falls
Virginia Commonwealth University VCU Scholars Compass Case Studies from Age in Action Virginia Center on Aging 1998 Medications and Falls Patricia W. Slattum Virginia Commonwealth University, pwslattu@vcu.edu
More informationClinical Care Program
Clinical Care Program Therapy for the Cardiac Patient What s CHF? Not a kind of heart disease o Heart disease is called cardiomyopathy o Heart failure occurs when the heart can t pump enough blood to meet
More informationPREVENTING AND MANAGING FALLS IN AGED CARE FACILITIES. Chris Shanley
NOTE: This pdf file has been created by scanning and OCR from the printed document. The layout, fonts and graphics used here try to match the original document, but there will be minor differences between
More informationTransmittal 55 Date: MAY 5, 2006. SUBJECT: Changes Conforming to CR3648 for Therapy Services
CMS Manual System Pub 100-03 Medicare National Coverage Determinations Department of Health & Human Services (DHHS) Centers for Medicare & Medicaid Services (CMS) Transmittal 55 Date: MAY 5, 2006 Change
More informationMobility After Stroke
Mobility After Stroke Issues facing stroke survivors and their families Regaining Mobility Moving around safely and easily is not something you may think about, until you have had a stroke. Each year more
More informationJill Malcolm, Karen Moir
Evaluation of Fife- DICE: Type 2 diabetes insulin conversion Article points 1. Fife-DICE is an insulin conversion group education programme. 2. People with greater than 7.5% on maximum oral therapy are
More informationMinimising the Risk of Falls & Fall-related Injuries. Education Supplement
Minimising the Risk of Falls & Fall-related Injuries Guidelines for Acute, Sub-acute and Residential Care Education Supplement Published by the Metropolitan Health and Aged Care Services Division Victorian
More informationAging in the Community
Ontario Health Technology Assessment Series 2008; Vol. 8, No. 1 Aging in the Community Summary of Evidence-Based Analyses October 2008 Medical Advisory Secretariat Ministry of Health and Long-Term Care
More informationIFA Senior Fitness Certification Test Answer Form
IFA Senior Fitness Certification Test Answer Form In order to receive your certification card, take the following test and mail this single page answer sheet in with your check or money order in US funds.
More informationon a daily basis. On the whole, however, those with heart disease are more limited in their activities, including work.
Heart Disease A disabling yet preventable condition Number 3 January 2 NATIONAL ACADEMY ON AN AGING SOCIETY Almost 18 million people 7 percent of all Americans have heart disease. More than half of the
More informationTitle: uthor: Background Knowledge: Local Problem: Intended Improvement:
1. Title: The Use of a Cognitive Aid within the Electronic Record can greatly improve the effectiveness of communication among care givers and reduce patient injuries from falls. 2. Author: M. Kathleen
More informationExtended Disability Income. Fixed cease age. Extended Disability Income. Whole Life UP TO 24 MONTHS. Pre-retirement.
For intermediaries Sanlam Risk Cover January 2015 Temporary Disability Income benefit (OIT3) Primary Income Protector benefits Waiting period Sickness Temporary Disability Income Including fixed payment
More informationUnderstanding the Aging Process: General Information, Risk Factors and Approaches to Care
Understanding the Aging Process: General Information, Risk Factors and Approaches to Care 1 Understanding the Aging Process In 2004, the life expectancy for the United States population reached a record
More informationDrug treatments for osteoporosis
Drug treatments for osteoporosis What is osteoporosis? Osteoporosis occurs when the struts which make up the mesh-like structure within bones become thin causing them to become fragile and break easily,
More informationDERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) OSTEOPOROSIS GUIDELINE
DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) OSTEOPOROSIS GUIDELINE This is an updated guideline It incorporates the latest NICE guidance There are strong recommendations for calcium + vitamin D
More informationFalls and Their Prevention in Elderly People: What Does the Evidence Show?
Med Clin N Am 90 (2006) 807 824 Falls and Their Prevention in Elderly People: What Does the Evidence Show? Laurence Z. Rubenstein, MD, MPH a,b, *, Karen R. Josephson, MPH b a Department of Medicine, David
More informationWhat You Need to Know for Better Bone Health
What You Need to Know for Better Bone Health A quick lesson about bones: Why healthy bones matter The healthier your bones The more active you can be Bone health has a major effect on your quality of life
More informationQuality Measures for Long-stay Residents Percent of residents whose need for help with daily activities has increased.
Quality Measures for Long-stay Residents Percent of residents whose need for help with daily activities has increased. This graph shows the percent of residents whose need for help doing basic daily tasks
More informationComplete Summary GUIDELINE TITLE. Prevention of fall injuries in the older adult. BIBLIOGRAPHIC SOURCE(S)
Complete Summary GUIDELINE TITLE Prevention of fall injuries in the older adult. BIBLIOGRAPHIC SOURCE(S) COMPLETE SUMMARY CONTENT SCOPE METHODOLOGY - including Rating Scheme and Cost Analysis RECOMMENDATIONS
More informationClinical Policy Title: Medical alert devices and other interventions for vulnerable peoples safety at home
Clinical Policy Title: Medical alert devices and other interventions for vulnerable peoples safety at home Clinical Policy Number: 17.01.02 Effective Date: April 1, 2015 Initial Review Date: January 21,
More informationHow To Determine If A Fall Prevention Program Is Effective
Clinical Policy Title: Medical alert devices and other interventions for vulnerable peoples safety at home Clinical Policy Number: 17.01.02 Effective Date: April 1, 2015 Initial Review Date: January 21,
More informationEfficacy and Tolerability of Antidepressant Duloxetine for Treatment of Hot Flushes in Menopausal Women
Efficacy and Tolerability of Antidepressant Duloxetine for Treatment of Hot Flushes in Menopausal Women Irina Shestakova, MD, PhD Research Center of Obstetrics, Gynecology and Perinatology Department of
More informationCompliance with drug therapies for the treatment and prevention of osteoporosis
Maturitas 48 (2004) 271 287 Compliance with drug therapies for the treatment and prevention of osteoporosis Jeffrey S. McCombs a,, Patrick Thiebaud b, Connie McLaughlin-Miley c, Jinhai Shi c a Department
More informationThese consequences include:
1 Slide 3 Introduction (Time for this section-10 minutes) These consequences include: Physical Discomfort and pain - caused by skeletal or soft tissue damage Serious injury Hypothermia, pressure-related
More informationPredicting Fall Risk in Acute Rehabilitation Facilities Stephanie E. Kaplan, PT, DPT, ATP Emily R. Rosario, PhD
Objectives Predicting Fall Risk in Acute Inpatient Rehabilitation Facilities Director of Rehabilitation and Director of Research Casa Colina Centers for Rehabilitation March 16, 2012 Current Falls Assessment
More informationLet s work together to prevent falls
Let s work together to prevent falls Let s work together to prevent falls Every year in New Zealand one in three people over the age of 65 will fall 1. For those aged over 80, the rate of falls is one
More informationOsteoporosis. Drugs to prevent bone fractures in people with: Contents. 2: Our Recommendations. 3: Welcome. 6: Who Needs Drugs to Prevent Fractures?
Drugs to prevent bone fractures in people with: Osteoporosis Comparing Effectiveness, Safety, and Price Contents 2: Our Recommendations 3: Welcome 6: Who Needs Drugs to Prevent Fractures? 8: Choosing a
More informationIf you fall or witness a fall, do you know what to do?
If you fall or witness a fall, do you know what to do? We all fall from time to time. With age, both the number of falls and the likelihood of injury increase. So, it s important to know what to do if
More informationSlips, Trips and Falls Avoid Them All A Falls Risk Reduction Program. Presenter's Guide And Participant Handouts
Slips, Trips and Falls Avoid Them All A Falls Risk Reduction Program Presenter's Guide And Participant Handouts Developed by: The NH Falls Risk Reduction Task Force January 2003 1 Slips, Trips and Falls
More informationFalls Management: Assessment & Intervention Approval Signature: September, 2012
Level: Policy ame: Falls Management: Assessment & Intervention Approval Signature: WRHA Policy #: Section: 1 of 7 Date: Original Signed by Sylvia Ptashnik, DORS September, 01 Safety & Comfort Supercedes:
More informationCan you do this in less than 12 seconds? YES NO
Why is falling a problem for farmers over 55? The risk of falling and being injured from a fall increases as people age. Preventing falls in older people is important because falls often result in serious
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: testing_serum_vitamin_d_levels 9/2015 2/2016 2/2017 2/2016 Description of Procedure or Service Vitamin D,
More informationFalls Prevention Strategy
Falls Prevention Strategy Policy of the Fall Season October-November 2011 Revised for CCTC By: Krista Shea RN, BScN, CNCC(C) Did you know In Canada: Falls are the 6th leading cause of death among older
More informationSlips, Trips and Falls Avoid Them All
Slips, Trips and Falls Avoid Them All A Falls Risk Reduction Program Presenter's Guide & Participant Handouts Developed by: The NH Falls Risk Reduction Task Force www.nhfallstaskforce.org 1 Slips, Trips
More informationSlips, Trips and Falls. Awareness Month. February 2005. Slips, Trips and Falls
THE SCHOOL DISTRICT OF PITTSBURGH Slips, Trips and Falls Awareness Month Joint Labor / Management Safety Committee Please open the attachment for additional information that will answer safety questions
More informationGUIDELINES FOR USE OF PSYCHOTHERAPEUTIC MEDICATIONS IN OLDER ADULTS
GUIDELINES GUIDELINES FOR USE OF PSYCHOTHERAPEUTIC MEDICATIONS IN OLDER ADULTS Preamble The American Society of Consultant Pharmacists has developed these guidelines for use of psychotherapeutic medications
More informationIdentifying and Reducing risk of falls in Older Adults
Identifying and Reducing risk of falls in Older Adults Help I m falling!!! Debra Hain, PhD, AGNP-BC Assistant Professor /NP Florida Atlantic University Christine E Lynn College of Nursing You need to know
More informationHormone Restoration: Is It Right for You? Patricia A. Stafford, M.D. Founder, Wellness ReSolutions
Hormone Restoration: Is It Right for You? Patricia A. Stafford, M.D. Founder, Wellness ReSolutions IMPORTANCE OF HORMONE BALANCE Importance of Hormone Balance Help you live a long, healthy life Help you
More informationThe type of cancer Your specific treatment Your pre training levels before diagnose (your current strength and fitness levels)
Exercise and Breast Cancer: Things you can do! Cancer within the fire service is one of the most dangerous threats to our firefighter s health & wellness. According to the latest studies firefighters are
More informationFear of falling in older people
Fear of falling in older people new findings from recent international research Presentation by Kim Delbaere Falls Prevention Symposium 2012 Catholic University Leuven 1.Fear of falling as a fall risk
More information